Healthcare Provider Details

I. General information

NPI: 1386527554
Provider Name (Legal Business Name): BRITTANY BOYER ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SILVA LN
MOBERLY MO
65270-3677
US

IV. Provider business mailing address

754 MEADOWBROOK CIR
MOBERLY MO
65270-3519
US

V. Phone/Fax

Practice location:
  • Phone: 660-263-6223
  • Fax:
Mailing address:
  • Phone: 660-651-7494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2012024113
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: